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Background: Lifestyle modifications, especially improving nutritional patterns and increasing physical activity are the most important factors in preventing obesity and metabolic syndrome in children and adolescents. For this purpose, the following interventional study was designed to investigate the effects of educational programs for students, as well as the changes in diet and physical activity on obesity and components of the metabolic syndrome. Methods: This study is part of an interventional research project (elementary school) conducted on all students of Sama schools in Zanjan and Abhar in three levels;elementary, middle and high school, including 1000 individuals in Zanjan (intervention group) and 1000 individuals (control group) in Abhar in 2011. Interventions were based on educating students, teachers and parents, changes in food services and physical activity. We primarily measured anthropometric indices, fasting blood sugar, lipid profiles and blood pressure and completed standard nutrition and physical activity questionnaires. Also, blood insulin levels were randomly measured in a number of students. Data analysis was done by SPSS software Version 16.0. Results: Overall, 589 individuals (252 males, 337 females) entered the case group and 803 individuals (344 males, 459 females) entered the control group. After two years of intervention, the mean waist circumference (63.8±10.9) and diastolic BP (63.8±10.4) were significantly lower, however, the mean systolic BP (10.1.0±12.5), food score (25.0±5.0) and drinking score (12.1±2.3) were higher in the intervention group (p<0.001). Comparing the components of metabolic syndrome between the second year and at the time of recruitment within the intervention group, showed that although the number of overweight/obese individuals, individuals with hypertriglyceridemia and high LDL increased, while those with abdominal obesity, high BP, hyperglycemia, and insulin resistance decreased (p<0.001). On the other hand, in the control group, the number of individuals with high BP increased significantly. Conclusion: The prevalence of abdominal obesity and hypertension, which are the two major components of metabolic syndrome, are much higher in our study than the other regions of the country. However, interventions for modification of diet and increasing physical activity, are effective in lowering of their prevalence.
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INTRODUCTION: Electrocardiographic (ECG) corrected QT (QTc) interval and dispersion were used as prognostic variables in adult patients and limited studies showed the relationship between QTc prolongation and dispersion with some clinical situations in newborn babies. AIM: In the present study, we compared the electrocardiographic (ECG) variables such as QTc interval and dispersion of healthy full-term and pre-term neonates with those who suffered from non-cardiac illnesses. METHODS: This prospective cohort study involved 127 neonates including four study groups: normal full-term neonates, ill full-term neonates, normal pre-term neonates and ill pre-term neonates. Neonates with fever, apnea, poor feeding, tachypnea, muscle retraction, grunting, reduced neonatal reflexes, positive blood culture or antibiotic therapy > 3 days were considered as ill neonates. QTc interval and dispersion were calculated and compared among the four groups. RESULTS: QTc interval was significantly (p = 0.012) higher in ill pre-term neonates in comparison with normal pre-term ones (418.74± 54.29 ms vs. 386.66± 39.26 ms). QTc dispersion was calculated and showed significantly higher mean values in ill pre-term neonates when compared with normal full-term, ill full-term and normal pre-term ones. QT dispersion and QTc dispersion of dead neonates were significantly (p= 0.0001-0.01) higher than alive ill pre-term neonates at 3, 7 and 28 days after birth. CONCLUSION: QTc interval and dispersion seem to represent non-invasive, reliable predictors of mortality in pre-term ill neonates, but further investigation is needed to confirm cutoff values for the risk assessment.
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BACKGROUND: HbA1C has been a known predictor and diagnostic test for diabetes type 2. However, this test has not yet been widely studied in GDM and more importantly no cutoff point has been defined for HbA1C in GDM. We investigated the efficacy of screening during first and second trimester of pregnancy and defined appropriate cutoff points according to HbA1C and FBS for predicting maternal GDM among women with none to minimal previously known risk factors. METHODS: This is a prospective multi-centered cohort study. Individuals were evaluated at first trimester, at 20-24 weeks and 24-28 weeks of gestation. GDM tests were done during visits and accuracy of each of these measurements was evaluated. RESULTS: Overall, 356 entered the study, among which 25 individuals and 30 individuals developed GDM during 20-24 and 24-28 weeks of gestation, respectively. HbA1C measured during first trimester at a cut-off of 5.35% predicted GDM of 24-28 weeks with an accuracy of 85.6%, sensitivity of 80%, and specificity of 80%. Furthermore, at a cut-off of 5.75% measured at 20-24 weeks, HbA1C predicted GDM with an accuracy of 94.5%, sensitivity of 97%, and specificity of 96%. CONCLUSION: Screening programs during first trimester and at 20-24 weeks of pregnancy, using HbA1C, can significantly aid in the early prediction of GDM, even among women with no to minimal previously known risk factors, which shows a need for revision in current guidelines.
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Specific local immunotherapy has been recently introduced as an alternative to classic subcutaneous immunotherapy in treatment of allergic rhinitis. In this study, the effects of sublingual immunotherapy (SLIT) on symptoms and medication score and skin prick test evaluation of patients with allergic rhinitis were investigated.In this placebo controlled trial, twenty four patients aged 5-18 years old with grass pollen induced rhinitis and sensitive to rye grass by positive skin prick test received randomly sublingual extract of rye grass or placebo for 6 months. Symptom and medication scores and adverse effects of SLIT were assessed during treatment. Skin prick test induced wheal at the beginning and the end of therapy were also measured. Data were analyzed with SPSS software.We found significant reduction of symptoms in intervention group from 21st week of immunotherapy (p<0.05). Medication scores were also reduced after 16th week (p<0.05), adverse effects were low and insignificant in both groups. Erythema induced diameter with skin prick test for grass and rye grass was significantly reduced in SLI group after immunotherapy.This study indicates that SLIT in grass-pollen rhinitis is well tolerated, improves overall clinical symptoms, and reduces drug consumes. We recommend this therapy as a safe therapy in patients with allergic rhinitis.